Treatment of recurrent glioblastoma: state-of-the-art and future perspectives

Nunno, Vincenzo Di; Franceschi, Enrico; Tosoni, Alicia; Battista, Monica Di; Gatto, Lidia; Lamperini, Cinzia; Minichillo, Santino; Mura, Antonella; Bartolini, Stefania; Brandes, Alba A.

doi:10.1080/14737140.2020.1807949

Cited by 30 publications

(32 citation statements)

References 94 publications

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“…Altered tumor vascularization is one of the hallmarks of the disease and there are at least two TK receptors whose inhibition could be associated with angiogenesis regression and tumor responses. These are the vascular endothelial growth factor receptor (VEGFR) and the platelet-delivered growth factor receptor (PDGFR) [16,29]. Several small TK inhibitors (TKIs) targeting one or both of these two receptors have been tested without significant benefit [16].…”

Section: Therapeutic Targets On Gbmmentioning

confidence: 99%

“…These are the vascular endothelial growth factor receptor (VEGFR) and the platelet-delivered growth factor receptor (PDGFR) [16,29]. Several small TK inhibitors (TKIs) targeting one or both of these two receptors have been tested without significant benefit [16]. Imatinib, pazopanib, cediranib, sunitinib, sorafenib, nintedanib, tivozanib, dovitinib, crenolanib, and cabozantinib are all oral TKIs that failed to show a significant clinical benefit on patients with GBM [16].…”

Section: Therapeutic Targets On Gbmmentioning

confidence: 99%

“…Several small TK inhibitors (TKIs) targeting one or both of these two receptors have been tested without significant benefit [16]. Imatinib, pazopanib, cediranib, sunitinib, sorafenib, nintedanib, tivozanib, dovitinib, crenolanib, and cabozantinib are all oral TKIs that failed to show a significant clinical benefit on patients with GBM [16]. The mesenchymal-epithelial transition (MET) receptor is another pathway that could be activated in GBM cells [30].…”

Section: Therapeutic Targets On Gbmmentioning

confidence: 99%

“…Recurrent GBM can be managed by different approaches [11][12][13], including locoregional treatment and systemic treatments [2,[14][15][16][17][18][19].…”

Section: Introductionmentioning

confidence: 99%

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Glioblastoma: Emerging Treatments and Novel Trial Designs

Nunno¹,

Franceschi²,

Tosoni³

et al. 2021

Cancers

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Management of glioblastoma is a clinical challenge since very few systemic treatments have shown clinical efficacy in recurrent disease. Thanks to an increased knowledge of the biological and molecular mechanisms related to disease progression and growth, promising novel treatment strategies are emerging. The expanding availability of innovative compounds requires the design of a new generation of clinical trials, testing experimental compounds in a short time and tailoring the sample cohort based on molecular and clinical behaviors. In this review, we focused our attention on the assessment of promising novel treatment approaches, discussing novel trial design and possible future fields of development in this setting.

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Section: Therapeutic Targets On Gbmmentioning

confidence: 99%

Section: Therapeutic Targets On Gbmmentioning

confidence: 99%

Section: Therapeutic Targets On Gbmmentioning

confidence: 99%

“…Recurrent GBM can be managed by different approaches [11][12][13], including locoregional treatment and systemic treatments [2,[14][15][16][17][18][19].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Glioblastoma: Emerging Treatments and Novel Trial Designs

Nunno¹,

Franceschi²,

Tosoni³

et al. 2021

Cancers

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“…While most intracranial neoplasms in adults have well-defined protocols for treatment, depending on tumor characteristics and location, the management of recurrent disease is often less standardized [1][2][3]. While usually benign, meningiomas can reoccur after primary resection, with WHO grade II/III tumors having significantly higher recurrence rates and shorter progression-free survival (PFS) [2,4].…”

Section: Introductionmentioning

confidence: 99%

Surgical Outcomes of Novel Collagen Tile Cesium Brachytherapy for Recurrent Intracranial Tumors at a Tertiary Referral Center

Warren¹,

Boucher²,

Bray³

et al. 2021

Cureus

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Treatment for recurrent intracranial neoplasms is often difficult and less standardized. Since its approval by the Food & Drug Administration (FDA), GammaTile TM (GT, GT Medical Technologies, Tempe, AZ), a novel collagen tile cesium brachytherapy, has been investigated for use in this population. This study presents the initial experience with the use of GT for patients with recurrent intracranial neoplasms at a tertiary referral center. A retrospective analysis of all patients with GT implantation from November 2019 to July 2021 was performed. Information regarding demographics, clinical history, imaging data, prior tumor treatment, dosing, surgical complications, and outcomes was collected. Twelve patients were included in this study. Pathologies included gliomas (five patients), meningiomas (five patients), and metastatic tumors (two patients). The median tumor volume treated was 24 cc (IQR: 21.2 - 31.3 cc), and patients had a median of 7.5 tiles implanted (IQR: 5.4 - 10.3). One patient had a delayed epidural hematoma requiring reoperation, which was unrelated to GT implantation. Median follow-up was seven months (IQR: 3 -10), with the longest follow-up time of 20 months. Two patients have had local disease recurrence and three patients have had systemic progression of their disease. Three patients are deceased with survivals of 2.9, 4.8, and 5.8 months. Collagen tile brachytherapy is a safe and viable option for patients with recurrent intracranial tumors. Our data are consistent with early results seen at other institutions. Long-term data with larger patient populations are required to assess efficacy, safety, and indications for the use of this novel technology.

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